Safety and efficacy of ledipasvir-sofosbuvir in black patients with hepatitis C virus infection: A retrospective analysis of phase 3 data.

UNLABELLED: Black patients chronically infected with genotype 1 hepatitis C virus (HCV) have historically had lower rates of response to interferon-based treatment than patients of other races. In the phase 3 ION program, the single-tablet regimen of the NS5A inhibitor ledipasvir and NS5B nucleotide polymerase inhibitor sofosbuvir was shown to be safe and highly effective in the general population. The aim of this study was to evaluate the safety and efficacy of ledipasvir/sofosbuvir in black patients using data from the three open-label ION clinical trials, which evaluated the safety and efficacy of 8, 12, and 24 weeks of ledipasvir/sofosbuvir with or without ribavirin for the treatment of treatment-naïve and treatment-experienced patients with genotype 1 HCV, including those with compensated cirrhosis. The primary endpoint was sustained virologic response at 12 weeks after the end of therapy (SVR12). For our analysis, rates of SVR12, treatment-emergent adverse events, and graded laboratory abnormalities were analyzed in black versus non-black patients. Of the 1949 patients evaluated, 308 (16%) were black. On average, black patients were older, had higher body mass index, were more likely to be IL28B non-CC, and had a lower serum alanine aminotransferase at baseline than non-black patients. Overall, 95% of black and 97% of non-black patients achieved SVR12. The rate of relapse was 3% in black patients as compared with 2% in non-black patients. The most common adverse events included fatigue, headache, nausea, and insomnia. The majority of adverse events occurred more frequently in the ribavirin-containing arms of the studies. No differences were observed in overall safety by race. CONCLUSION: A once-daily dosage of ledipasvir/sofosbuvir was similarly effective in black and non-black patients with genotype 1 HCV infection. The addition of ribavirin did not appear to increase SVR12 but was associated with higher rates of adverse events.

Parental Bereavement: Looking Beyond Grief - Challenges and Health

For most parents there is no imaginable event more devastating than the death of their child. Nevertheless, while bereaved parents grieve they are also expected to carry on with their life. The day-to-day activities that were once routine for these parents may now be challenging due to the emotional turmoil they are experiencing. To date parental bereavement has been described as complex, intense, individualized, and life-long and their grief responses are interwoven with their daily activities, but the nature of their daily life challenges are not known.

This dissertation highlights the significance of how parents respond to their bereavement challenges because bereaved parents have higher morbidity and mortality rates than non-bereaved parents or adults who have lost their spouse or parents. Many bereaved parents in their daily routines include activities that allow them to maintain a relationship with their deceased child. These behaviors have been described as “continuing bonds”, but with this dissertation the continuing bonds concept is analyzed to provide a clear conceptual definition, which can be used for future research.

Using the Adaptive Leadership Framework as the theoretical lens and a mixed method, multiple case study design, the primary study in this dissertation aims to provides knowledge about the challenges parents face in the first six months following the death of their child, the work they use to meet these challenges, and the co-occurrence of the challenges, and work with their health status. Bereaved parents challenges are unique to their individual circumstances, complex, interrelated and adaptive, as they have no easy fix. Their challenges were pertaining to their everyday life without their child and classified as challenges related to: a) grief, b) continuing bonds, c) life demands, d) health concerns, f) interactions, and g) gaps in the health care system. Parents intuitively responded to the challenges and attempted to care for themselves. However, the role of the healthcare system to assist bereaved parents during this stressful time so that their health is not negatively impacted was also recognized. This study provides a foundation about parental bereavement challenges and related work that can lead to the development and testing of interventions that are tailored to address the challenges with a goal of improving bereaved parents health outcomes.

Dynamic Programming Approaches for Estimating and Applying Large-scale Discrete Choice Models

People go through their life making all kinds of decisions, and some of these decisions affect their demand for transportation, for example, their choices of where to live and where to work, how and when to travel and which route to take. Transport related choices are typically time dependent and characterized by large number of alternatives that can be spatially correlated. This thesis deals with models that can be used to analyze and predict discrete choices in large-scale networks. The proposed models and methods are highly relevant for, but not limited to, transport applications. We model decisions as sequences of choices within the dynamic discrete choice framework, also known as parametric Markov decision processes. Such models are known to be difficult to estimate and to apply to make predictions because dynamic programming problems need to be solved in order to compute choice probabilities. In this thesis we show that it is possible to explore the network structure and the flexibility of dynamic programming so that the dynamic discrete choice modeling approach is not only useful to model time dependent choices, but also makes it easier to model large-scale static choices. The thesis consists of seven articles containing a number of models and methods for estimating, applying and testing large-scale discrete choice models. In the following we group the contributions under three themes: route choice modeling, large-scale multivariate extreme value (MEV) model estimation and nonlinear optimization algorithms. Five articles are related to route choice modeling. We propose different dynamic discrete choice models that allow paths to be correlated based on the MEV and mixed logit models. The resulting route choice models become expensive to estimate and we deal with this challenge by proposing innovative methods that allow to reduce the estimation cost. For example, we propose a decomposition method that not only opens up for possibility of mixing, but also speeds up the estimation for simple logit models, which has implications also for traffic simulation. Moreover, we compare the utility maximization and regret minimization decision rules, and we propose a misspecification test for logit-based route choice models. The second theme is related to the estimation of static discrete choice models with large choice sets. We establish that a class of MEV models can be reformulated as dynamic discrete choice models on the networks of correlation structures. These dynamic models can then be estimated quickly using dynamic programming techniques and an efficient nonlinear optimization algorithm. Finally, the third theme focuses on structured quasi-Newton techniques for estimating discrete choice models by maximum likelihood. We examine and adapt switching methods that can be easily integrated into usual optimization algorithms (line search and trust region) to accelerate the estimation process. The proposed dynamic discrete choice models and estimation methods can be used in various discrete choice applications. In the area of big data analytics, models that can deal with large choice sets and sequential choices are important. Our research can therefore be of interest in various demand analysis applications (predictive analytics) or can be integrated with optimization models (prescriptive analytics). Furthermore, our studies indicate the potential of dynamic programming techniques in this context, even for static models, which opens up a variety of future research directions.

Pollen and macrofossil profiles from six cores in Illinois, U.S.A

Pollen analysis of Wisconsinan sediments from eleven localities in northern and central Illinois, combined with the results of older studies, allows a first general survey of the vegetational changes in Illinois during the last glaciation. In the late Altonian (after 40,000 B.P.), pine was already the most prevalent tree type in northern Illinois. Probably because of the influence of the last Altonian ice advance to northern Illinois, pine migrated to the south and reached south-central Illinois, which was at that time a region of prairie, with oak and hickory trees in favorable sites. Likewise in the late Altonian, spruce appeared in northern Illinois. Spruce also expanded its area to the south during the Wisconsinan, reaching south-central Illinois only after 21,000 B.P., in the early Woodfordian. Deciduous trees (predominantly oak) were present in south-central Illinois throughout the Wisconsinan. Their prevalence decreased to the north. The vegetation during the different subdivisions of the last glacial period in Illinois was approximately as follows: Late Altonian: Pine/spruce forest with some deciduous trees in northern and central Illinois; prairie and oak/hickory stands in south-central Illinois; immigration of pine. Farmdalian: Pine/spruce forest in central Illinois; deciduous trees and pine in south-central Illinois, with areas of open vegetation, perhaps similar to the present-day transition of prairie to forest in the northern Great Plains. Woodfordian: Northern and central Illinois ice covered; in south central Illinois, spruce and oak as dominant tree types, but also pine and grassland. During the Woodfordian, pine and spruce disappeared again from south-central Illinois, and oak/hickory forest and prairie again prevailed. The ice-free areas of northern Illinois become populated temporarily with spruce, but later there is proof of deciduous forest in this region. Pollen investigations in south-central Illinois have shown convincingly that deciduous trees could survive relatively close (less than 60 km) to the ice margin. Therefore the frequently presented view that arctic climatic conditions prevailed in North America during the last glaciation far south of the ice margin can be refuted for the Illinois area, confirming the opinion of other authors resulting from investigations of fossil mollusks and frost-soil features. The small number of localities investigated still permits no complete reconstruction of the vegetation zones and their possible movements in Illinois. During the Altonian and Farmdalian in Illinois, a vegetational zonation probably existed similar to that of today in North America. As the ice pushed southward as far as 39° 20' N. lat in the early Woodfordian, this zonation was apparently broken up under the influence of a relatively moderate climate. In any case, the Vandalia area, which was only about 60 km south of the ice, was at that time neither in a tundra zone nor in a zone of boreal coniferous forest.

Bailando con Dioniso: el mito de Leucipo y Daphne de Richard Strauss y Joseph Gregor

Primera parte de un artículo dividido en dos que analiza la profunda reinterpretación que del mito de Dafne llevaron a cabo, a partir del relato alternativo de Partenio de Nicea más que del célebre relato de Ovidio, Richard Strauss y su libretista Joseph Gregor en su versión operística Daphne (1938). El objetivo final es someter a examen la declaración expresa de Strauss sobre el significado de su nueva ópera y si a través de la manipulación del argumento mítico los autores lograron alcanzar su objetivo.

Item and task difficulty in a B2 reading examination: perceptions of test-takers and CEFR alignment experts compared with psychometric measurements

The article presents a study of a CEFR B2-level reading subtest that is part of the Slovenian national secondary school leaving examination in English as a foreign language, and compares the test-taker actual performance (objective difficulty) with the test-taker and expert perceptions of item difficulty (subjective difficulty). The study also analyses the test-takers’ comments on item difficulty obtained from a while-reading questionnaire. The results are discussed in the framework of the existing research in the fields of (the assessment of) reading comprehension, and are addressed with regard to their implications for item-writing, FL teaching and curriculum development.

Prevalence and risk of Down syndrome in monozygotic and dizygotic multiple pregnancies in Europe: implications for prenatal screening

OBJECTIVE: To determine risk of Down syndrome (DS) in multiple relative to singleton pregnancies, and compare prenatal diagnosis rates and pregnancy outcome.

DESIGN: Population-based prevalence study based on EUROCAT congenital anomaly registries.

SETTING: Eight European countries.

POPULATION: 14.8 million births 1990-2009; 2.89% multiple births.

METHODS: DS cases included livebirths, fetal deaths from 20 weeks, and terminations of pregnancy for fetal anomaly (TOPFA). Zygosity is inferred from like/unlike sex for birth denominators, and from concordance for DS cases.

MAIN OUTCOME MEASURES: Relative risk (RR) of DS per fetus/baby from multiple versus singleton pregnancies and per pregnancy in monozygotic/dizygotic versus singleton pregnancies. Proportion of prenatally diagnosed and pregnancy outcome.

STATISTICAL ANALYSIS: Poisson and logistic regression stratified for maternal age, country and time.

RESULTS: Overall, the adjusted (adj) RR of DS for fetus/babies from multiple versus singleton pregnancies was 0.58 (95% CI 0.53-0.62), similar for all maternal ages except for mothers over 44, for whom it was considerably lower. In 8.7% of twin pairs affected by DS, both co-twins were diagnosed with the condition. The adjRR of DS for monozygotic versus singleton pregnancies was 0.34 (95% CI 0.25-0.44) and for dizygotic versus singleton pregnancies 1.34 (95% CI 1.23-1.46). DS fetuses from multiple births were less likely to be prenatally diagnosed than singletons (adjOR 0.62 [95% CI 0.50-0.78]) and following diagnosis less likely to be TOPFA (adjOR 0.40 [95% CI 0.27-0.59]).

CONCLUSIONS: The risk of DS per fetus/baby is lower in multiple than singleton pregnancies. These estimates can be used for genetic counselling and prenatal screening.

Flow Regime Identification Methodology with Mcnp-X Code And Artificial Neural Network

This paper presents flow regimes identification methodology in multiphase system in annular, stratified and homogeneous oil-water-gas regimes. The principle is based on recognition of the pulse height distributions (PHD) from gamma-ray with supervised artificial neural network (ANN) systems. The detection geometry simulation comprises of two NaI(Tl) detectors and a dual-energy gamma-ray source. The measurement of scattered radiation enables the dual modality densitometry (DMD) measurement principle to be explored. Its basic principle is to combine the measurement of scattered and transmitted radiation in order to acquire information about the different flow regimes. The PHDs obtained by the detectors were used as input to ANN. The data sets required for training and testing the ANN were generated by the MCNP-X code from static and ideal theoretical models of multiphase systems. The ANN correctly identified the three different flow regimes for all data set evaluated. The results presented show that PHDs examined by ANN may be applied in the successfully flow regime identification.

Workforce Patterns and the Prevention of Mother-to-Child Transmission of HIV Option B Cascade in Côte d'Ivoire

Thesis (Master's)--University of Washington, 2016-08

Rheology of bituminous mastics and mortars containing crumb rubber from tyres: a novel dry-hybrid technology

This report studied the effect of crumb rubber in the asphalt mixture. The mixtures were also having limestone filler as a modifier. Mastic and mortar (mastic-fine aggregate system) mixture having different quantities of crumb rubber and limestone filler modifiers have been tested in order to find the best rutting resistance combination with an acceptable stiffness. The rheological tests on bituminous mastics and mortars have done in the laboratories in Nottingham Transport Engineering Centre (NTEC) and University of Bologna (DICAM). In the second chapter, an extensive literature review about the binders, additives, asphalt mixtures, various modelling and testing methods have been reviewed. In the third chapter, the physical and rheological properties of the binders have been investigated using both traditional devices and DSRs. The forth chapter is dedicated to finding the behaviour of the modified mastics (Binder-modifier system) with different combinations. Five different combinations of crumb rubber and limestone filler mastic tested with various methods using Dynamic Shear Rheometers. In the fifth chapter, in order to find the effect of the modifiers in the rheological properties of the complete asphalt mixture, the fine aggregates added to the same mastic combinations. In this phase, the behaviour of the system so-called mortar; binder, rubber, filler and fine aggregates) has been studied using the DSR device and the traditional tests. The results show that using fine crumb rubber reduces the thermo sensibility of the mastic (Binder Bitumen System) and improves its elasticity. Limestone filler in the other hand increases the mixture stiffness at high Frequencies. Another important outcome of this research was that the rheological properties of the mortars were following the same trend of the mastics, therefore study the rheological properties of the mastic gives an upright estimation of the mortar.

A Comparison of Subjective Experiences and Responses to Austerity of UK and Greek Youth. GreeSE Paper No.102

Following previous research carried out by Chalari (2014; 2015), this qualitative study explores the ways in which the younger generation in Greece and UK has been affected by austerity policy measures. These two countries have been at the forefront of intense social, political and economic transformations that have impacted particularly on young people’s current and future lives. This study aims to explore similarities and differences in young people’s subjective experiences and responses, as from this it may be possible to discern whether there is a general, long-term negative effect of austerity across Europe. The data shows that there are some similarities in the two cohorts’ subjective experiences and responses, but perhaps more interestingly some significant differences. The study discusses what the implications of these differences might be for young people and society in these countries, in terms of their impact on the abilities of the younger generation, in a way that has the potential to destabilize their personal and professional lives now and in the future.

How Do Young People Talk About Relationships?

Interpersonal relationships are important for young people’s social, emotional and mental wellbeing. Educational Psychologists in their work with children, young people and families play a role in promoting the social, emotional and mental wellbeing of young people. A review of previous literature suggested that young people’s voice is missing from much of the research about relationships. This research is positioned within an ontological perspective of social constructionism. It aimed to explore ways in which a group of Year 8 students used their language to talk about relationships; what meaning they drew from them, who they have relationships with and what is important about them. 13 Year 8 students participated in the study and their views were explored using semi-structured interviews. Data gathered was then scrutinised using a discourse analysis technique. Three broad discourses were drawn upon by participants: ‘Social Contract’, ‘Interpersonal Aspects’ and ‘Relationship Diversity’. Within each of these there were smaller sub-discourses and interpretive repertoires drawn upon by participants to convey action and function within their talk. Participants considered relationships as very important, though they rejected the notion of a single construct of relationships, choosing instead to draw upon relationships with different people as different types of relationship. Friendship was the primary type of relationship which young people spoke about, however, they often constructed their discourse to undermine the importance of these friendships. The research findings were incorporated within the wider literature and relevant links have been drawn between the study and psychological theories. Implications for the work of Educational Psychologists were also discussed, in terms of utilising relationships for interventions and supporting those working with young people to consider young people’s views and meaning making about relationships.

DYNAMICS OF THE SHORT TERM AND LONG TERM AVIAN DISTRIBUTIONS IN NORTH AMERICA - THE ROLES OF VEGETATION HEIGHT HETEROGENEITY AND CLIMATIC FACTORS

Understanding how biodiversity spatially distribute over both the short term and long term, and what factors are affecting the distribution, are critical for modeling the spatial pattern of biodiversity as well as for promoting effective conservation planning and practices. This dissertation aims to examine factors that influence short-term and long-term avian distribution from the geographical sciences perspective. The research develops landscape level habitat metrics to characterize forest height heterogeneity and examines their efficacies in modelling avian richness at the continental scale. Two types of novel vegetation-height-structured habitat metrics are created based on second order texture algorithms and the concepts of patch-based habitat metrics. I correlate the height-structured metrics with the richness of different forest guilds, and also examine their efficacies in multivariate richness models. The results suggest that height heterogeneity, beyond canopy height alone, supplements habitat characterization and richness models of two forest bird guilds. The metrics and models derived in this study demonstrate practical examples of utilizing three-dimensional vegetation data for improved characterization of spatial patterns in species richness. The second and the third projects focus on analyzing centroids of avian distributions, and testing hypotheses regarding the direction and speed of these shifts. I first showcase the usefulness of centroids analysis for characterizing the distribution changes of a few case study species. Applying the centroid method on 57 permanent resident bird species, I show that multi-directional distribution shifts occurred in large number of studied species. I also demonstrate, plain birds are not shifting their distribution faster than mountain birds, contrary to the prediction based on climate change velocity hypothesis. By modelling the abundance change rate at regional level, I show that extreme climate events and precipitation measures associate closely with some of the long-term distribution shifts. This dissertation improves our understanding on bird habitat characterization for species richness modelling, and expands our knowledge on how avian populations shifted their ranges in North America responding to changing environments in the past four decades. The results provide an important scientific foundation for more accurate predictive species distribution modeling in future.

COACHES, CLIMATES, “FIELD” GOALS, AND EFFICACY: A “DE-CONSTRUCTION” OF THE MASTERY-APPROACH TO COACHING AND EXAMINATION OF RELATIONSHIPS TO PSYCHOSOCIAL OUTCOMES IN A YOUTH FOOTBALL PLAYER DEVELOPMENT PROGRAM.

In support of the achievement goal theory (AGT), empirical research has demonstrated psychosocial benefits of the mastery-oriented learning climate. In this study, we examined the effects of perceived coaching behaviors on various indicators of psychosocial well-being (competitive anxiety, self-esteem, perceived competence, enjoyment, and future intentions for participation), as mediated by perceptions of the coach-initiated motivational climate, achievement goal orientations and perceptions of sport-specific skills efficacy. Using a pre-post test design, 1,464 boys, ages 10-15 (M = 12.84 years, SD = 1.44), who participated in a series of 12 football skills clinics were surveyed from various locations across the United States. Using structural equation modeling (SEM) path analysis and hierarchical regression analysis, the cumulative direct and indirect effects of the perceived coaching behaviors on the psychosocial variables at post-test were parsed out to determine what types of coaching behaviors are more conducive to the positive psychosocial development of youth athletes. The study demonstrated that how coaching behaviors are perceived impacts the athletes’ perceptions of the motivational climate and achievement goal orientations, as well as self-efficacy beliefs. These effects in turn affect the athletes’ self-esteem, general competence, sport-specific competence, competitive anxiety, enjoyment, and intentions to remain involved in the sport. The findings also clarify how young boys internalize and interpret coaches’ messages through modification of achievement goal orientations and sport-specific efficacy beliefs.

Development of new vocational training modules on sustainable buildings maintenance and refurbishment

This article presents the methodology and main results obtained in Spain within the FORMAR project, a European-funded project under the Leonardo Da Vinci scheme (Lifelong Learning Programme), whose main goal is to jointly develop training resources and modules to improve the skills on sustainability issues of buildings maintenance and refurbishment workers, in three different European countries: Spain, Portugal (Project Coordinator) and France. The Units of Short-term Training (UST) developed within this project are focused on the VET of carpenters, painters, bricklayers, building technicians and installers of solar panels, and a transversal unit containing basic concepts on sustainable construction and nearly Zero Energy Buildings (n-ZEB) is also developed. In parallel, clients’ guides for the aforementioned professionals are also implemented to improve the information provided to clients and owners in order to support the procurement decisions regarding building products and materials. Therefore, the project provides an opportunity to exchange experiences between organizations of these three European countries, as the UST will be developed simultaneously in each of them, exploring opportunities for training, guidance and exchange of experience. Even though the UST will have a common structure and contents, they will be slightly different in each country to adapt them to the different specific training needs and regulations of Spain, Portugal and France. This paper details, as a case study, the development process of the UST for carpenters and building technicians in Spain, including the analysis of needs and existing training materials, the main contents developed and the evaluation and testing process of the UST, which involves the active participation of several stakeholders of this sector as well as a classroom testing to obtain the students’ feedback.